mHealth Speaker/Panel Sessions (AM)

The days mHealth talks started with a couple of sessions headlined by the following vague description:

“mHealth is proving to be more than just another technology bridge it is transforming our view of healthcare services. A number of challenges need to be overcome to ensure a smooth transition from services delivered through traditional means to services delivered via mobile technology. This session will look at how synergies can best be achieved between embedded and handheld devices, and the platforms required to deliver them”.

The unconfirmed opening keynote was delivered by Terry Kramer, Regional President, Vodafone Americas (despite noises suggesting it would be Ryuji Yamada, President & CEO, NTT Docomo):

A speaker from the smaller mHealth session last year, Terry is familiar with the mHealth space and gave a broad overview although I think we’d have got more value if we heard from his colleague Joaquim Croca, Head of mHealth at Vodafone Global Enterprise, about what’s happening at the mHealth coal face with the worlds largest mobile company (Check out my review of Vodafone’s Exhibiton stand mHealth Demo).

Instead of being told that “the environment is right for significant advances”, or that “there have been huge advances since last year’s announcement” I think we’re at a stage where it would have been better to hear what these are and get some examples.

Terry’s keynote was followed by a joint presentation by Dr Ajay Bakshi, Associate Principal and Alessio Ascari, Director, McKinsey:

Which has gone down as one of the poorest quality research reports I’ve heard since I was in school.

The report tried to stick a measure on the consumer appetite for mHealth services and used the results of 3000 interviews that lasted an hour each and took place across 6 different countries (500 in each country). As part of these interviews 4 types of “suggested future mHealth services” were explained breifly:

Following this the answers to questions such as “What do think of these mHealth services?”, “Do you like them?”, “How much would you pay for them?” were collected.

The McKinsey consultants then proclaimed a global interest in mHealth because 69% of all the people they interviewed said they were interested in at least 1 product. What’s more they then used this to suggest there was a potential gold mine for mobile operators in GSM “Health Watches” in addition to mobiles “as an extra subscription”.

Unfortunately this is a complete an utter pipe dream, and were it not presented at this global focal point for the mobile industry having cost over $200,000 to research I would not even consider writing about this pointless effort. But to summarise:

> The nature of new services is underpinned by the fact that people don’t necessarily always know that they need something. Just like we didn’t know we’d ever want the Camera Phone, or the MP3 Music Playing Phone or the VideoPhone there is no point basing your future on asking people what they want and how much they’d be prepared to pay for it. What’s more the self identified needs of patients are a particularly poor prediction of the future as most of them aren’t even sick yet.

> From personal experience (I’ve had loan of a Watch Phone) I know how far removed this style of device is from the average consumers imagination (even without the additional health monitoring/service functionality):

When I took it off and let people handle it themselves they still found it hard to believe it was actually a perfectly functioning mobile phone – and this was amongst a group of highly qualified UK Doctors who have mostly been using smartphones for years. To my mind the suspension of belief that the interviewers expected of their subjects is so wide that the feedback they got is inconsequential.

I wonder if the interviewer had asked them if they’d like a Rolls Royce whether they’d have presented this $200k research paper at the Detroit Motor Show and advised motor industry big wigs that there is a unmet demand for $500,000 vehicles amongst 90% of the global population – after all who wouldn’t like one of them?

> 2 devices or 1. The history of convergence points towards the mobile taking over the functionality of this supposed extra subscription device eg. I can already point you to a variety of phones on the exhibition floor that offer all of this functionality eg. Activity Monitoring (Endomondo), SOS buttons (Senior Phones) and more (NTT Docomo) on a conventional handset.

The research went on then to build models for categories to pigeon hole patients as “worriers” (20% of German customers), Wellness Conscious, Convenience Seekers (who doesn’t want a bit of that?!) which is some of the most pointless pieces of type casting I’ve ever heard. Not only does this type casting have no way of differentiating the ”Undiagnosed” from the “Worriers” but it shows no way to account for the rapid changes that occur with an individual/family as a result of onset of illness. On top of this I personally hate the term “worried well” as I find it’s more often than not used by those who are ignorant of the opportunity presented by the engaged patient. Why not just be a bit more honest and just brand them as “troublesome”. Isn’t it weird how outside of the world of Healthcare it’s unusual to find commercial companies complaining about their fans or using depreciative terms to describe those wanting to actively engage with them eg. Loyal Customer, Platinum Member etc.

The next claim was an equally ridiculous assumption again based on this poor quality research. Apparently delegates were to go away thinking “India is happy to pay $2 per call and drug delivery is the big thing”.

The consultants didn’t even for one moment reflect on the evidence that suggests call centres that don’t offer continuity of care are a proven waste of money and the potential they have to undermine the normal growth of local health services and help create a dangerously inefficient case mix that would deter even the most committed Doctors from trying to make a living in a remote Indian village.

The conclusion of this ramble from McKinsey was another number that I’m sure lots of “.com make-believe-entrepreneurs” will want to include in the business plans they’ll no doubt be taking to Venture Capitalists… The Global mHealth Opportunity is worth $50-60 Billion and more than 50% of this is related to connected bio sensor devices.

Take my advice: If you’re following these guys your train has already left the station. Not only does the last “connected bio sensor device category” undermine the entire report (mobiles are already powerful biosensors but we’ve just not all learnt how to listen yet!) but it also shows a wide eyed ignorance as he then went on to talk up the GE VScan Device as an example of one such product (does he know this can only be used by a trained and experienced professional?).

As if to ensure all doubt was removed the consultants then proved definitively that they have little/any appreciation of a Doctors skill set by suggesting that the GE VScan device was “much more powerful than the hands and eyes a Doctor uses” (a ridiculous statement that Dr Sally Stansfield thankfully corrected – at my request! – in the following Q&A).

In summary Dr Ajay Bakshi (who for some reason also decided to stand in front of his projected images throughout the talk) told the audience that the “Mobile Phone is not going to start helping Brain Cancers” which reminds us of the importance of imagination and intelligence in creation of mHealth services – please learn the value of mobile video content (eg. the patient benefits of a Harley Street TV Video comforting a diagnosed patient and their family/friends with an explanation, an idea of the treatment and some supportive information about the challenges they face) or the potential to detect early brain functioning changes via monitoring performance of patients using touch interface BrainGame activities on their always carried mobile.

Next up was a panel session discussing “Supply Side EcoSystem and the mHealth Value Chain” featuring: (L to R) Dr Sally Stansfield, Exec Secretary, Health Metrics Network, WHO, Peter Hakansson, Senior Research engineer, Ericsson, Sung S Han, VP for Research and Development, LG, Alvaro Fernandez de Araoz, eHealth Director, New Growth, Telefonica, Shahid Ahmed, Partner, Network Technologies Wireless Practice, Accenture and Prashant Yadav, Professor of Supply Chain Management, MIT-Zaragoza.

Dr Sally Stansfield opened up with a “spine chilling” insight into what mHealth now means for the developing world by explaining her first hand experience working in Ethiopia where she encountered a particularly bloody experience where a patient died because there was no ability to get them to a distant hospital. Two years later when a similar story unfolded the result was much more positive: “the SMS was sent and not before long we heard the motorcycle drawn cart arriving to take the patient to hospital”
Peter Hakansson started with a comment about how pleased he was to be talking this week on their stand with Mobile Network Operators who were very interested in trying to launching new mhealth services. See my separate post on this busy exhibition area). He then reminded us of how quickly the infrastructure is now expanding and the need to ensure that services can be successful from the commercial perspective of network operators. He also expanded on the enormous opportunity for scale that we can enjoy as a result of the intra-operability issues that are now resolved.

Peter wrapped up with the suggestion that “what is needed is not only a mobile phone but a more sophisticated device really”, whilst I have great respect for Peter and loved the work he showed on the Ericsson exhibition spacein Hall 5, I cannot see this long held technologists dream from materialising until someone can show me a sensor that is more powerful than the potential we already have with Smart, always carried internet connected devices that we already carry everywhere.

Yes (as Google CEO Eric Schmidt reminded us) connected medical devices are no doubt capable of being interesting, but if they’re not leveraging the patient owned mobile we’ll just see low market adoption and dead ends exactly like that which Sung S Han (R&D @ LG) later reported on the “home Doctor video link” services that failed in Korea (see below).
Sung S. Han was up next and started by describing how “Health is a big issue, a world issue, the US is a mess, but that’s another story” which led to a recommendation to the excellent Clayton Christian book The Innovators Prescription.

Sung gave insight into the focused needs of a mobile manufacturer: more handsets and delivering more value to users. He also followed consensus on how developing world adoption can be faster because healthcare system may not exist but challenged the ethicacy of cheaper lower cost care and asked “What can we attach to remotely monitor”. He also shared details on the Korean Government plans to open up patient data over the next few years and reminded us of something I couldn’t agree more with: “Doctors control the system. If we can deliver a way to make them more money, they’ll come right along with us”.

He talked about how LG started looking at the mHealth area for the last 2 years but the Korean experience shows what happens when you launch services that don’t leverage the inherent unique advantages of the platform: patients just wont sign up or use them.

The Home Health Stations that LG extensively trialled in a country where most handsets sold are actually 2nd handsets (more on the developed Korean ecosystem can be found in the book Digital KoreaURL) proved to be so unappealing that after 6 months they closed it down. Sung suggested that the Korean market had little demand for mobility when IPTV and large plasma TVs are commonplace. But the real lesson for me was when Sung said “patients couldn’t see the benefit when they could just go around the corner to visit their normal Doctor face to face because Korea has one of the highest Doctor/Patient ratios of anywhere in the world” (it is roughly about the same per capita as France or Germany)

As I’ve said before on this blog and Tomi Ahonen definitely puts to rest over at his blog: The exact same thing happened in the early days of newspapers, radio, TV and the Internet. What won at the end of the day was new services based on the unique benefits of the new mass media. No one plays radio ads on the TV anymore. Don’t try and replicate “Normal Doctor Visits” or “eHealth” on mobiles. LG HAVE PROVEN IN THE WORLDS MOST ADVANCED MOBILE MARKET THAT THIS WILL NOT WORK. mHealth may let you see the Doctor (via 3G Video Calling), but that in itself is not the opportunity after all millions of people can already do that on Skype with their PCs (and soon on their TVs thanks to an initiative with LG!). mHealth is about leveraging the unique abilities of mobiles as the newest (and least understood) mass media.

If we look to areas where health needs are not being sufficiently addressed in Korea (eg. suicide amongst successful males) surely this is where personally relevant videos on an individuals handset, not a shared device, can help: it’s obvious to anyone that we’re not going to be able to even begin to try and manage the issues of male suicide through video calls on the plasma screens in the family lounge.
Alvaro Fernandez de Araoz opened with an one liner that was a useful reminder of the reality for the mobile operators: “Oh and its our job to sell all this in 3 minutes”. Which is also a good test of the “patient need” focus that I apply to what we offer here at 3G Doctor (e.g. “Video Call an informed Doctor”, “Create, Manage & Share your important Health Information”, “watch videos of specialists talking about the health issues you’re facing” etc).

Alvaro talked of his Pharma background in the USA and role now at Telefonica heading up 50 engineers in Granada, Spain. “Our challenge is the carrot: Doctor gets paid for walking through the Door”

Even though I hear this all the time I can’t help but disagree with it. It’s too simplistic. Being a Doctor is a life long career and as such Doctors get paid for their brand, and that isn’t made up by having a door adjoining a waiting room. It’s something that’s built up through their contribution to medical science, successful outcomes, personality, reputation etc.

Alvaro also stated: “We’re not Doctors and we need to partner. We will not ever offer a direct to consumer mHealth Service”. Which again I disagree with even though it may be the current consensus (Orange’s Michael Reilly -quoted below- also states the same). I think we have a tyranny of consensus building here, when everyone agrees on something it usually means they’re all wrong. I think it’s only because of the immaturity of the mHealth market that they’re saying this. In other mobile content markets operators cry out that they add value and that they’re not just dumb pipes. Mark my words: this tune will quickly change when the mobile operators see the revenue, profitability and customer loyalty that will be generated by advanced mHealth services and start looking for their cut of the action.

Alvaro also stated that “We need to see that remote services produce the same outcome for patients”. I again disagree, we should be trying to make them better – something that is most definitely possible if you leverage the unique new advantages of mobile as the newest mass media.

Alvaro continued with “Grey Haired Doctors wont be taught new things… Doctors tend to be artists and aren’t aligned with EHRs… if the customer doesn’t really know what he wants… 17 local governments in Spain make it even more difficult…” and a final point endorsing a paint by numbers approach that could work for mHealth.

The mHealth industry must be very careful not to fall for the “it’s good enough for you but not for me” blind alleys that this paint by numbers approach to medicine is typical of. Yes a tick box approach may be good enough for 90% of your customers but BEFORE it has any chance of commercial success you need to ask is it good enough for you? For your parents? Children? Because this is the test that patients will apply to it before even considering changing their behaviour.
Shahid Ahmed talked about how they are seeing the “Stars Aligning for mHealth” and made vague points explaining how they see it as akin to the music download or mobile banking services:

1) “Regulations changing everywhere”
2) “Devices changing, more powerful for example there was a RSNA published study recently into the ability to view CTA scans 125 Doctors and only 1 error, now its not statistically correct research but its heading…. imagine when the GE Device can say similar…”
3) “Networks getting better, apart from AT&T with the iPhone”

Yes there are no doubt lessons to draw from the other parts of the mobile service industry (don’t try to reinvent for mHealth) but it’s a bit hard for me to take seriously a panelist who undermines his mHealth credentials by incorrectly referring to a CT scan as a “CTA Scan”. It comes as no surprise to see he has no healthcare experience in his bio, I can only presume it was the Accenture brand that got this guy a seat which is disappointing as there are plenty of people who know about and are doing interesting things in the world of mHealth who could have benefited from this visibility whilst informing the audience.
Prashant Yadav made the final panel contribution before a Q&A and used it to describe the opportunity for mHealth to “improve access to medications by reform of the supply chain” delivered with the unreassuring caveat “I don’t have any knowledge of Mobile Phone Technology”. Apparently “monitoring the supply of medications would be a space that would pick up quicker than the direct to consumer”. Whilst mindful of the potential for the mobile phone of a Pharmacist to help improve the very complex and inefficient supply chain (I’m also a big fan of Pharmacists accessing resources on their smartphones) I would tend to disagree with this advice on the basis that corruption and changing working practices often present a bigger adoption barrier than there is to be found with a direct to consumer approach such as the demonstration we got from the Sproxil exhibition stand.
Next up was a panel session discussing “Revenue Streams for mHealth – Exploring the future economics of mHealth” featuring: (L to R) David Aylward, Exec Director, mHealth Alliance, Bob Isherwood, Chief Creative Dude, i.e. healthcare, Michael Reilly, Director of Healthcare, Orange and Clint McClellan, Sr Director of Market Development, Qualcomm.

David Aylward (who I’ve quoted before on my blog) was brief and started with recognition of the help he’s had from Mital Shah, who is departing the mHealth Alliance to join the West Wireless Health Institute, before introducing Bob IsherWood and the global challenges of Maternal Health and Childcare that his organisation is working with ieHealthcare to tackle. In the Q&A though he did a great job of summing up what I think these mHealth sessions in Barcelona should have been all about and should have tried harder to achieve (sadly I’m pretty sure they failed as a result of poor organisation and disappointing attendance levels that I have mentioned here):

having been around the US Congress most of my career, which is why I have no hair, I would encourage everyone to speak to their legislators in whatever country you’re from and the press wherever you’re from because I can assure you they do not understand this issue, don’t understand the benefits of it. And if they did, they would start pushing on the reimbursement. The “Number One” Advocate for mHealth in the United States should be the Medicare Programme. I can guarantee you that there is nobody in the Medicare programme with any authority who is focused on this issue. The second biggest pusher should be the Medicard programme in the US, and I guarantee you there is no one in the Medicaid programme who is focused on this issue who has the authority to make decisions. And it’s most likely that they will start paying attention when they get a call from the Hill saying “Hey, what’s your mHealth Strategy?”. There has been a whole bit of politics to this which some people call “lobbying” and some people call “education” but it depends on what job you have what you call it

As I find myself continually reminding others, Health and Education are no longer separate from Telecoms. The pervasive capacity and reach of the mobile now means your Minister of Telecoms is also your Minister of Health and Minister of Education – even if they don’t fully appreciate it yet.
Bob Isherwood followed David Aylward’s introduction by explaining very succinctly what is drawing such top talent from diverse other sectors (check out his creative/advertising background) to the challenges of this market: “This is such a huge opportunity to not only do well, but to do good, which of course is one of the whole attraction of using mobiles in the Healthcare space”.

“This is a consumer need that’s very real and it’s also very big and it’s worldwide. Right now we’re trying to help the mHealth Alliance with the problem in Africa… …the problem is that 536,000 women die in childbirth per year and more than half of those are in Africa”

Bob went on to list some opportunities for mobiles to help:

> Able to help identify the mothers to be that are at risk
> Provision of Checklist kinds of information
> Training of midwives
> The potential for the multimedia abilities of a mobile phone to serve patients that are illiterate
> Opportunity for these systems to be built for the developed markets and applied to Africa that’s great

Bob also elaborated on how we can engage with consumers before they become patients by making the shift from the philosophy of “push” to “pull” and explaining how “transactions are going to become value exchanges” where you get the ad as a by product of the information. He also referred to these exchanges as “Customer managed interactions” – where consumers will be able to sell their data – with the proviso that companies wanting to “engage with people” will “need to start with that emotional connection because if you don’t start with that you’re not going to make any connection at all”.
Michael Reilly outlined what the Healthcare unit within Orange/France Telecom that he heads up is doing:

“In Mali with the Orange Foundation we’ve actually been testing a project where using SMS effectively to actually measure the weight of young infants and through SMS text messages they are sent to a central repository and the weight of the children, a significant number, being regioned out to communities where local people actually execute that function and is it a major project by the Mali government, Orange foundation… to actually reduce malnutrition as a direct intervention. Now the UK as in Africa every intervention technically must have evidence and must be measureable to show that the intervention has been effective and we are working and investing in a project in Eygpt where we will be looking at remote dermatology, a telemedicine dermatology solution which is still under investigation with a view to reducing the cost of access to a primary specialist and actually having the inital diagnostics done by a junior specialist for the benefit of the community using 3G or higher resolution camera and that is probably the latest study of what we’re doing in this space”

Mike also explained in the Q&A how Orange are seeking to make the emotional connection with the “elderly or the ill” by “partnering with organisations that work in that domain”. And then in a somewhat conflicting statement defined who he felt was the future buyer of mHealth:

“for elderly parents, it will probably not be them it’ll be the 45, 55 and 65 year old daughter as they live longer”

Before elaborating on what the CEO of a leading UK Charity for the elderly recently told him:

“There are 2 killers of people over the age of 65 in the United Kingdom, Malnutrition and Loneliness”

Before stating that their research in Grenoble revealed that it will probably be a multimedia approach using the TV Remote Control that will prove most successful.
Clint McClellan introduced how the West Wireless Institute has been founded with the goal of taking systems and running them through clinical trials so they can get to market faster and be adopted more quickly in the clinical world.

He talked of how as a technology company Qualcomm always knew that connecting patients and Doctors with their data was a huge opportunity but that it was always going to be just two dimensional in the sense that their drive was to just make it cheaper over time and add functionality, but that what they now need to add is the third dimension which is the “emotional component” that “people like Bob Isherwood” can bring to this industry – because if you “left it to us” we’d have just made a system that sent out a “don’t touch the cookie and no one will get hurt” message when you exceeded your calorific limit.

Clint outlined how their Wireless Reach programme in Portugal that was supplying 3G base stations into the homes of the elderly with a Video Camera was proving very successful and gaining acceptance amongst seniors as a “trusted tool”.

Clint McClellan also made a great point on the need to promote the return on investment of mHealth innovations in addition to the need that David Aylward had made lobbying for reimbursement:

“Reimbursement is vital and we can’t wait for it in the sense that it’s like a HIPAA file it’s so random! Does anyone know of Cardionet? Cardionet was the world’s first remote diagnostic company probably 7 years ago, they do arrhythmia detection, the Doctor will send you the kit, you wear it for 2 weeks, it finds the arrythmia. 300% more effective than existing techniques.. well arbitarily someone at Medicaid (although I think he meant to say Medicare) decided that $1,100 per session was too much. They just cut it to $700, just out of the blue, so there’s a certain randomness that’s there that we must work with and lobby against but on the other hand we still need to go forward and promote the ability to return on investment. There’s another company coming up called Corventis, they make a patch that records heart rate, temperature, motion and they do fluid detection. The key to fluid detection is that an increase in fluid will indicate the onset of a heart attack so something like 60% of post heart operation patients come back within 30 days you send them hoime and they come back and it costs something likke $30-60,000 to see them again. They can’t get a reimbursement code yet for that but the payers are slowly beginning to realise “Wait a second, if I get a patch on these people for 30 days they’re not going to come back” so payers are slowly beginning to realise that there’s a return on investment, so that in addition to throwing as much ‘power up to the hill’ as we can, “the Hill” we call our Washington DC, to put lobbyists in there, and that’s a lot of the great work that Continua is doing, we also have to promote a return on investment that will occur as well. So these are the keys: as much as we need the reimbursement we need to also promote the Return on Investment equally as well”

Following the panel talks David Aylward asked for some “questions from the floor” which disappointedly both originated from individuals who were already directly involved in the organisation of the event which I felt prevented new issues and potential contributors from participating:

First was from Karl Brown, Associate Director of the Rockefeller Foundation (a founding partner of the mHealth Alliance) who asked about the issues of User Interface standards (an area that I frequently seem to be hearing newbies to this space raising alarm about):

My question is about standards. so I think we know that the proliferation of mobile health applications standards for exchange of information at the back end are very good but these aren’t visible to the users and i think the other set of standards that are going to be important are interface, and around interface paradigms because if i’ve got my glucose monitor and my heart monitor and the screens look completely different the data is presented in a totally different way and i have a different log in and all this stuff then so it’s confusing from the user with this proliferation of mobile applications and i’m wondering from the design perspective what do you think about having a sort of common interface patterns for mobile health so that the consumers don’t get confused by the interface paradigm”.

Whilst Michael Reilly defended his company’s line on this by quoting Oranges support for the Continua Alliance, Clint was more expressive in reminding the audience of the need for the free market to be allowed to decide these:

I actually sit on the board of Continua and it’s painful as you try to determine single radios, multiple radios and there’s this balance we need to find which is we can’t hinder the market with too much standardisation in the sense that for example Dr Gao in the front row over here (Read my blog post on IVT Corporation) has built an entire system with a blood pressure monitoring cuff, non continua based but it’s Bluetooth and it works, I had a Continua system based on Bluetooth and it kept on crashing, so there’s a certain point where you need the free market to come in and work… just last week we had two other radios that raised their hand and want to be standardised and our point all along has been, my personal point is the market has to be allowed to work and it will hopefully figure its way out, but there have to be certain specifications so Continua has chosen one Bluetooth specification and we need to do some more work with it because there are many flavours of Bluetooth, many different profiles, Bluetooth low energy is coming up next (read my MWC2010 review of Bluetooth Low Energy here) but we need to make sure that we’re open enough so that other radios can compete because we don’t know what’s going to happen and just last week i raised my hand, I stood up at Continua and I gave that example about the radios with 3G, we didn’t know 3G was going to come 3 years ago we really didn’t (Thankfully we did!) and my point to them was if someone came to us 10 years ago said “Alright the use case is the cellphone”, we’d still have analogue! We need to keep it open enough so that specifications get built. So I wouldn’t worry about the user interface, those are expert systems that we need to come in. Nike will come in and they’ll have a specification that shows you a happy face or a sad face, whatever it is, it gets all that biometric data and gives you feedback and there will be winners and losers at that and Nike will have them, Adidas will have them, so in a certain extent we need to be open enough to allow these technologies to pervade and also to have some specifications, so within Continua we are trying to do that and what we want to do is if there’s Bluetooth there is one specification of Bluetooth because you can go in different ways and we’ll keep going along that way to make sure there are choices but if you’re from health industry coming in they’ll know what to do

To my mind an 8 year old can see that separate devices with their own UI’s don’t work together very well, but that’s just one of the reasons why convergence to the mobile has happened for a whole range of things like calculators, messaging pagers, cameras, alarm clocks, dictaphones, MP3 Players, GPS, etc and will continue to happen (please read my “Nokia Decade in Pictures” post if you are in doubt about these matters). It’s also to the benefit of a principle enabler of this market (the handset device manufacturers) who use their UI’s to differentiate their devices from those of competitors.

I’m not sure it’s clear enough that no one knows how this market will unfold, we don’t even know what devices patients will be using by the time this all becomes a mass market proposition. So to worry about developing common interfaces for blood pressure monitors to share with heart monitors is pointless if the future mass market application for both of these sensors is that the two devices become obsolete and are replaced by a body worn stick on patch that monitors other (related) biological parameters and uses Bluetooth low energy to communicate through my mobile directly with my connected health record in the cloud.

To illustrate the point that this isn’t some distant future that we’ll have to wait on, on this years exhibition floor I reported on two examples of working technologies that make these UI requirements (that Karl is calling for) obsolete:

1) The Nuance technology which powered the Voice Recognition Search demo by Eric Schmidt. This avoids the need for any UI – the mobile just listens to you to know that you’ve done something (eg. “putting on my Coventis plaster”, “coughing” with a bout of pneumonia, unscrewing my medication dispenser and swallowing a tablet, etc, etc). Voice Recognition could also be used together with other biometric data to ensure much better authentication processes than a “password” (that once compromised could easily be used by anyone).

2) Bluetooth Low Energy. One of the “Eurekas” of this technology is that it avoids the need for any on-device UI for the medical device. Instead it just automatically communicates through your mobile phone to your connected health record. Patients can then just easily use a native app which can present their health dashboard like that we use in motor vehicles today.
Next up was a question to the panel from Mitul Shah, Managing Director of the mHealth Alliance (the organisers of the session):

The question that was brought up and I think to some degree not completely answered, assuming there is an answer just yet, on the whole idea of reimbursement, the idea of health insurance or other powerful entities that are going to make this sustainable. I’ve had many conversations with Doctors from various different healthcare providers all interested in what we’re talking about but at the end of the day they’re just not seeing an incentive for them to get on their cellphone to answer the call to make the extra effort to be able to do things outside of their provision of what’s actually being covered. what, from your perspective, and this is a question for all three of you, or four of you, where do you see this needs to go if we’re all meeting in a year from now, who do we need on this panel for the further revenue stream to help answer some of those questions and hopefully provide more insight on how to get to that level sooner or later

Unsurprisingly this took the panel off on tangents, eg, Michael Reilly:

“procurement is done by procurement specialists and therefore I was very careful to make sure that within our strategy as a company we have to attend to their specific drivers and needs and the effectiveness and efficiency of technology deployment has not been hallmarked in the United Kingdom with great success. We’ve had to learn not to repeat the sins of the past but to implore technical technology deployments where there is manifest and clear understanding of the needs of the payer and the procurement process and also the IT administrators who have to deal with our technology as well as obviously attending to the ultimate needs of the patient and the clinicians”

Considering this was the only session of the entire 4 day conference where a confirmed speaker didn’t even bother to turn up (Dr Ganapathy/Sangita Reddy from a Healthcare provider: Apollo Health) I think the lesson here couldn’t be clearer: Until you can show the clinicians that what you’re offering is better than what they are already are making do with, adoption will continue to disappoint and as Sung Han explained market failure awaits you until you begin to leverage the 8 unique benefits of mobile as the newest mass media in the design of your mHealth services.


The next panel session concluded the morning and discussed “Wellness at Every Age – The Role of mobile technology in preventing illness and its overall impact on critical care” and featured: (L to R) Dr Hector Gallardo, General Director, Carlos Slim Institute, Dr Michael Swiernik, UCLA, Malinda Peeples, VP for Healthcare Integration, Well Doc and Dr Sooryul Lee, Team Leader of U Health Project, ETRI

To be completed…

…To be continued, please accept apologies. This post is awaiting content to be uploaded…

This blog post is part of a series of mHealth reviews from the Mobile World Congress 2010. Click here to get the full review.

5 thoughts on “mHealth Speaker/Panel Sessions (AM)

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